Innovating Approaches in Promoting Physical Activity: The Agita São Paulo Experience

Sedentarism is a worlwide problem with important implications on morbi-mortality, and health costs. However, combacting sedentariness and promoting physical activity is a quite high challenge, at both individual but particularly at populational level. If in one hand scientific evidences are strong and universal, in the other hand succesful approaches that overcame the academic level are rare. Then, it is the desire of this presentation to discuss the lessons learned from sucessful interventions, based upon  the expericence of Agita Sao Paulo. Agita Sao Paulo was launched in 1996 with the main purpose of promoting physical activity in a population of 36 million inhabitants in the state of Sao Paulo, Brazil.  Among the strategies used, Agita developed the "Mobile Management" the ecological model proposed by Sallis and Owen that involves a: Intrapersonal, b- Social Environment, and c- Natural and Constructed Physical Environmental factors. The program has as its foundation the popularization of a clear downright message within the community and the establishment of alliances with both governmental and nongovernmental organizations in order to ensure the diffusion of the health promotion message aimed at fostering more active lifestyle: to accumulate at least 30 minutes of moderate physical activity per day, most part of the days of the week. The Program has three focuses -adolescents, workers, and older adults - including the conduction of Mega-Events and permanent actions with associated institutions that execute specific activities for each focus. Impact evaluation has also comprised the conduction of specific studies of intervention in focal groups that have changed their behavior and improved their awareness of physical activity in the community.  Awareness of the Program’s name and objective has also been determined to have progressively grown over the years of intervention from the increased percentage of the population that became aware and changed their physical activity levels. Both the Program’s impact and the propagation of its actions, beyond the State’s boundaries, that have been implemented nationwide and internationally, have been scientifically assessed. Indeed,  at present there are eighteen similar physical activity promotion programs in place in Latin America, comprising the Americas Network of Physical Activity (PANA/RAFA). As consequence of the outstanding success of World Health Day celebration (2002), Agita Mundo/Move for Health Network was lauched (2003), and World Active Day (Agita Mundo/Move for Health Day) has been involving thousands events in many countries.  Among the positive lessons explaining the increase in level of physical activity and knowledge about the health benefits of active living observed in that population, it might included: a- the multisectorial approach; b- the vastly use of partnership; c- the inclusion principle; d- scientific basis; e- unpaid media; f- "two-hats" approach; g- cultural adaptation and pleasure; h- clear, simple and feasible message; and i- impact evaluation. Those reasons also make the Agita Sao Paulo a model that could be used in other countries as an effective way to promote health through physical activity.